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Updated: Sep 3, 2025
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Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
Published on: August 4, 2023
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[Recurrent epistaxis with coagulation disorders in a boy aged 2 years]
Jia-Zhuo Li1, Xin Tian1, Chu-Shu Liao
1Department of Hematology and Oncology, First Affiliated Hospital of Hunan Normal University/Children's Medical Center, Hunan Provincial People's Hospital, Changsha 410005, China.
Summary
This case study highlights hypoprothrombinemia-lupus anticoagulant syndrome, a rare bleeding disorder. Early diagnosis through specific coagulation tests is crucial for effective treatment and improved patient outcomes.
Area of Science:
- Hematology
- Pediatric Medicine
- Clinical Immunology
Background:
- Recurrent epistaxis in children can indicate underlying coagulation disorders.
- Prolonged activated partial thromboplastin time (APTT) necessitates further investigation into specific clotting factor deficiencies and inhibitors.
Observation:
- A young boy presented with recurrent epistaxis and significantly prolonged APTT.
- Laboratory tests revealed the prolonged APTT was uncorrected, with positive lupus anticoagulant and low prothrombin activity.
Findings:
- The patient was diagnosed with hypoprothrombinemia-lupus anticoagulant syndrome.
- Treatment with glucocorticoid, immunoglobulin, and vitamin K1 led to clinical improvement, normalized prothrombin activity, and persistent positive lupus anticoagulant.
- Six-month follow-up showed no recurrence of epistaxis.
Implications:
- This rare syndrome requires specific diagnostic tests, including APTT correction and lupus anticoagulant assays.
- Early detection and prompt, targeted treatment can significantly improve prognosis in patients with bleeding symptoms and coagulation abnormalities.
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